Insomnia is the most common sleep problem reported by adults.
Approximately one-half of all adults have occasional sleep problems during the course of any year.
Insomnia is characterized by the inability to fall asleep or to maintain sleep, usually due to an underlying condition or cause.
Both men and women of all ages suffer from insomnia, but it is more common in females and older adults.
Individuals suffering from insomnia may experience any or all of the following symptoms:
- Difficulty falling asleep
- Difficulty staying asleep
- Waking too early in the morning
Insomnia is also often associated with concomitant emotions and states, including:
- Unrefreshing sleep, and/or
- Daytime fatigue.
Likewise, medical or psychiatric concomitant conditions sometimes associated with insomnia include:
- Substance abuse disorders
- Obstructive sleep apnea
- Restless legs syndrome, and
- Chronic medical conditions.
Medications and other substances, including caffeine, alcohol, and nicotine, can also play an important role in the development or persistence of insomnia.
Some commonly used medications - such as antidepressants, antihypertensives, antihistamines, and decongestants - have known associations with insomnia and sleep disruption.
It is very important to discuss your concerns about any medication with your prescribing physician or naturopathic physician, and to only withdraw or eliminate any medication under the supervision of such an experienced health care professional to avoid any complications of medication withdrawal or elimination.
Insomnia Progression & Prognosis
For many people with insomnia, the symptoms last a few days to weeks, and then resolve spontaneously.
In many of these cases, the underlying cause of insomnia can be seen to be a transient life stress or change in daily routine.
However, for those who have chronic insomnia - which is defined as persisting for three months or longer = the effects of poor sleep can take a significant, sustained, and unrelenting toll on quality of life and general well-being.
The effects of chronic insomnia may include:
- Reduced quality of life
- Impaired social functioning
- Diminished work productivity
- Missed work days
- Impaired memory and concentration, and
In essence, chronic insomnia can rob individuals of their ability to function both socially and professionally.
In addition to decreased job performance, insomnia is associated with increased absenteeism.
People with insomnia are at increased risk for various kinds of accidents, both at work and while operating motor vehicles.
Treating Insomnia by Treating The Whole
In a case such as this, in which the patient’s presenting symptoms are relatively common and have vast differential diagnoses, particular attention must be paid to the naturopathic principles of treating the whole person.
If, for instance, the patient’s insomnia is rooted in a childhood trauma or personal loss, suppressing these symptoms may actually act as an obstacle to curative healing.
Persistent insomnia and anxiety may, for instance, hint at underlying unresolved grief and pain.
Suppressing such symptoms with a superficial treatment - whether pharmaceutical, herbal, or homeopathic - would prevent such a patient from true emotional healing.
That is not to say that pharmaceutical, botanical, and/or homeopathic remedies do not have a place in such patients.
Simply that they must be targeted.
Sedate or Tonify - Nervines vs. Adaptogens
For instance, from a botanical perspective, a patient whose insomnia is associated with anxiety and nervousness may respond most optimally to particular, individually-selected botanical sedatives and nervines.
On the other hand, insomnia stemming from adrenal fatigue may respond better to the introduction of adaptogens with overall relaxing properties to balance and tonify the nervous and endocrine systems.
Examples of such potentially soothing adaptogens include:
- Withania somnifera (Ashwagandha)
- Elethrococcus senticosum (Siberian ginseng), and
- Bupleurum falcatum (Chinese thoroughwax)
Please note that, in contrast to the sedating adaptogenic properties of Siberian ginseng, the related, similarly-named, but decidedly-distinct species commonly known as Korean ginseng or simply "ginseng" (Panax ginseng) is generally quite stimulating.
Every patient is unique and will respond to a given herb, drug, or homeopathic in their own unique manner.
That notwithstanding, however, herbal Panax ginseng is generally ill-advised for insomnia, as it may even worsen sleeplessness due to its generally-stimulatory nature.
Insomnia, Cortisol, and Adrenal Fatigue
In early stages of adrenal stress, cortisol levels rise while DHEA levels fall.
In more chronic stages of adrenal burnout, both the cortisol and DHEA levels are decreased.
Cortisol varies during the day and night according to a predictable 24-hour cycle.
It is typically at its highest around 8:00 am, and lowest between midnight and 4:00 am.
A single sample of cortisol does not tell the full story because, depending on the individual’s stage of adrenal exhaustion, cortisol values can be either above or below normal ranges.
Therefore, to accurately access adrenal function, specialized labs have developed a 24-hour cortisol profile using saliva samples taken at four different times during one 24-hour day.
Fortunately, the degree of adrenal fatigue can also be assessed with simple, quick, and non-invasive in-office testing.
For instance, I generally provide such testing to my patients as a component of their visits, for no additional charge.
Essential Oils for Insomnia
Note that, for skin application, the essential oil must be diluted in a vegetable carrier oil, such as cold-pressed sunflower oil or sweet almond oil.
Accordingly, please be advised that none of the information provided constitutes treatment advice, as individual responses to generally-safe treatments and posologies may vary widely.
Additionally, as you are an individual, your optimal treatment involves individualized dosing of an essential oil that is likewise individually matched to your unique constellation of symptoms by an experienced and knowledgeable health care professional.
Subject to the above caveat, typical essential oil posologies are as follows:
- Adults: 7 -10 drops of essential oil to 25 mL (5 tsp) of carrier oil
- Children (between ages 3- 7): 3-5 drops of essential oil to 25 mL (5 tsp) of carrier oil
- Infants (between age 2-3) 1-3 drops of essential oil to 25 mL (5 tsp) of carrier oil
- Newborns (under age 2): None / do not use.
Inhalation is generally an effective mode of essential oil delivery.
One or two drops of relaxing oil may be placed onto a handkerchief and tucked inside your pillow to aid your sleep.
A relaxing bath with soothing essential oils, such as Chamaemelum nobile (Roman camomile) and Pelargonium graveolens (geranium) may also assist in unwinding before sleep.
A nervine effect may be provided by many oils, including:
- Chamaemelum nobile (Roman camomile),
- Lavender angustifolia (lavender),
- Citrus aurantium subsp. amara / Bigaradia (neroli),
- Rosa damascena (rose), and/or
- Origanum majorana (marjoram).
A few drops added to your bathwater or sprinkled on a handkerchief and inhaled may produce calming or nervine effects.
The following essential oils may be useful for management of sleep.
STYRAX BENZOIN (BENZOIN)
Benzoin is generally a sedative, warming, and relaxing essential oil.
It may be useful for sleeplessness caused by worry, emotional exhaustion, or tension, as well as for other symptoms such as bronchitis and coughs.
However, note that benzoin sensitivities and allergies are not uncommon, and this oil should only be used under direction of an experienced health care professional.
MATRICARIA CHAMOMILLA (GERMAN CHAMOMILE)
Chamomile generally calming for both the nervous and gastrointestinal system, is often helpful in promoting sleep, and is especially indicated for children.
It may be useful for insomnia, anxiety, and gastrointestinal upset.
However, as chamomile is a member of the sunflower / ragweed (Asteraceae) botanical family, sensitivities and allergies - particularly those producing dermatitis, sinus congestion, and even fevers, have been reported.
JASMINUM OFFICINALIS (JASMINE)
Jasmine is typically relaxing and soothing, and has antidepressant, sedative, aphrodisiac, and expectorant actions.
It tends to be non-toxic and non-irritant in most individuals.
Jasmine may be useful for insomnia, depression, apathy, nervous exhaustion, stress, catarrh, and breathing difficulties.
LAVENDULA OFFICINALIS (LAVENDER)
Lavender is generally soothing to both nervous and gastrointestinal systems, and has pain-relieving, antidepressant, and antihypertensive actions.
It also tends to be non-toxic and non-irritant.
Lavender may be useful for insomnia, tension, depression, headache, catarrh, stomach cramps, shock, and earache.
MELISSA OFFICINALIS (LEMON BALM)
Lemon balm is generally relaxing and uplifting, lowers blood pressure, and may have additional benefits for digestion, menstruation, and the nervous system.
It may be useful for insomnia, nervous tension, depression, high blood pressure, hyperthyroidism, indigestion, coughs, colds, shock, and anxiety.
However, as Lemon balm may precipitate skin irritation, small amounts only are advised.
CITRUS AURANTIUM AMARA (NEROLI)
Neroli is often relaxing, non-toxic, and non-irritant.
It may be useful for insomnia caused by anxiety, depression, irritability, panic, and shock.
SANTALUM ALBUM (SANDALWOOD)
Sandalwood is typically relaxing, and has aphrodisiac, antidepressant, expectorant, and gastrointestinal-calming actions.
It tends to be non-toxic and non-irritant.
Sandalwood may be useful for insomnia, depression, nervous tension, catarrh, and colic.
CANANGA ODORATA (YLANG YLANG)
Ylang ylang is generally relaxing, and has aphrodisiac, antidepressant, antihypertensive, and nervous system tonic actions.
It tends to be non-toxic and non-irritant.
Ylang ylang may be useful for insomnia, depression, stress, nervous tension, and excitability.
- If unable to sleep, don't stay in bed - get up and do something both physically and mentally non-stimulating until you feel as if you can sleep.
- Get up at the same time every day, including on the weekends.
- Avoid alcohol, caffeine and nicotine in the hours before bedtime.
Treating Chronic Insomnia Naturally
Fortunately, there is natural, safe, and effective treatment available to treat insomnia.
Cognitive Behavioural Therapy (CBT) insomnia treatment
Research and clinical experience alike has demonstrated that - when combined with appropriate and individually-selected remedies - cognitive behavioural therapy (CBT) can be very effective in the treatment of sleep disorders, including insomnia.
CBT is a series of behavioral interventions used to improve your ability to initiate and maintain sleep.
Specifically, CBT is a group of techniques that can be learned to help you sleep better.
Generally, CBT is conducted in individual or small group formats over a period of several weeks.
As alluded to above, CBT is most successful in conjunction with individually-selected medication - herbal, homeopathic, or pharmaceutical - for the treatment of chronic insomnia.
That notwithstanding, treatment with medication is not required in every case.
Cognitive Behavioural Therapy Insomnia Treatment Techniques
Cognitive Behavioural Therapy (CBT) encompasses several different techniques, which may be used together or individually.
These techniques include:
- Sleep hygiene training
- Relaxation therapy
- Stimulus control therapy
- Sleep restriction, and
- Cognitive therapy
1. Sleep Hygiene Training
Sleep hygiene training refers to introducing and relearning habits that encourage and promote your sleep.
For instance, maintenance of a quiet sleep environment may mean excluding your pet from the bedroom, or getting your partner to receive treatment for a chronic snoring problem.
2. Relaxation Therapy
Relaxation therapy helps you to reduce physiologic and cognitive arousal at bedtime.
You may be surprised how much even seemingly-minor subconscious tension and stress can negatively impact your sleep.
3. Stimulus Control Therapy
Stimulus control therapy works by limiting the presence of external stimuli or factors that may bring anxiety or stress into the bedroom environment.
Implementation of this technique can help to establish your bedroom as a place to relax and unwind, away from the stresses of the world.
4. Sleep Restriction
Sleep restriction limits the amount of time you spend lying awake in bed.
This technique requires close oversight by a physician or psychologist, using sleep diaries, to ensure successful treatment.
5. Cognitive Therapy
Cognitive therapy works to refute an individual's thoughts about sleeplessness and the fear and anxiety related to these thoughts.
Cognitive therapy provides practical and effective tools to help alleviate or eliminate insomnia.
Botanical Remedies for Insomnia
WITHANIA SOMNIFERA (ASHWAGANDA)
Ashwaganda is a useful sedating tonic for many patients with adrenal fatigue.
Despite its relaxing activity, this herb is otherwise regarded as having adaptogenic potential equal to that of Panax ginseng, in terms of its tonic, stamina-improving properties.
Ashwaganda has the ability to slow various aspects of the aging process, stimulate the endogenous production of melanin, normalize low sperm count, improve sexual performance, and increase general resistance to stress - physical, chemical, and/or biological.
Ashwaganda may also be useful for treating connective tissue disorders, hypotension, and cancer.
It is highly praised in Ayurveda as having broad uses for multiple ailments.
This herb also exerts anti-inflammatory, hypotensive, hepato-protective and anti-bacterial actions.
Finally, Ashwaganda is high in several nutrients, including iron, arginine and ornithine.
SCHIZANDRA CHINENSIS (SCHISANDRA / WU WEI ZI)
Schisandra - known in Traditional Chinese Medicine (TCM) as wu wei zi - is traditionally used as a blood purifier where the liver is under functioning.
It is often applied in cases of both acute and chronic liver disease, particularly when the liver requires protection and detoxification.
Schisandra would be particularly indicated if the patient were under stress, especially if this stress had to do with liver impairment.
Such liver impairment may be induced by a variety of factors, including drug, alcohol, and/or environmental toxicity, as well as specific infective organisms.
Schisandra may also improve memory and brain functioning, co-ordination, and sensory functions, due to the apparent actions on the central nervous system that it exerts.
Other conditions that may benefit from using Schisandra include wheezing, spontaneous sweating, nocturnal emission, chronic diarrhea, insomnia, and forgetfulness.
In TCM, wu wei zi is thought to act on the kidneys, thereby regulating the flow of Qi through the body
ASTRAGALUS MEMBRANACEUS (ASTRAGALUS, HUANG QI)
Astragalus has a revered reputation as an adaptogen for chronic stress, and as a specific tonic for strengthening resistance to disease.
It possesses antiviral activity, which it appears to generate by enhancing the production and secretion of interferon, increasing the function of natural killer (NK) cells, and increasing IgA, IgE, and IgM antibodies.
Astragalus also exerts an invigorating action on cell metabolism and aids adrenal function.
Astragalus is used in states of chronic debility, fatigue, and where restoration to immune function is required.
It is reputed as an anti-aging tonic, assists in relieving menopausal symptoms such as night sweats, and has applications in supporting cancer treatments.
Studies using extracts of Astragalus on sperm production has shown outstanding results.
Some studies suggested that Astragalus outperformed all other herbal medicines in its potential to increase sperm number and motility.
Astragalus also may help to expel toxins and pus.
It is a lung and cardiac tonic, and has applications for conditions such as nephritis, hypoglycemia, and fungal infections.
AVENA SATIVA (OATS)
Oats - particularly in forms such as oat seed or milky oat straw - is considered very useful for soothing and restoring the action of a debilitated and overtired nervous system.
Consequently, oats tend to be most indicated in of insomnia secondary to exhaustion, nervous debility, and/or depression.
Oat seed also has beneficial applications in reproductive dysfunction, particularly where nervous system involvement is indicated.
Like many seeds, it exerts actions on the genitourinary system.
ELEUTHROCOCCUS SENTICOSUS (SIBERIAN GINSENG)
Siberian ginseng has a reputation as a rejuvenator of general health, longevity, and memory.
It tempers the over-activation of the adrenal cortex in response to stress and prevents thymus and general lymphatic damage.
As a relaxing adaptogen, Siberian ginseng may also permit greater levels of stress-inducing stimuli from adverse physical conditions to be withstood.
It may yield increased mental activity and improved athletic performance.
Siberian ginseng tends to be notably less stimulating than its relative Panax ginseng (Ginseng / Korean ginseng)
As a result, Siberian ginseng may prove more beneficial at reducing fatigue and enhancing chronic immune function.
This herb also has ability to improve kidney function and regulate blood pressure.
Finally, Siberian ginseng demonstrates activity as an immune stimulant - most notably by increasing Helper T-cells and Natural Killer (NK) cell activity.
Individualized Insomnia Treatment with Naturopathic Medicine
The cognitive, herbal, and behavioural treatments mentioned above represent just the tip of the iceberg for the naturopathic treatment of insomnia.
All such treatments have accumulated evidence of success in treating insomnia in a given subset of patients or for large cohorts.
However, please note that this does not guarantee that any given treatment - behavioural, cognitive, herbal, homeopathic, or pharmaceutical - will work for a given individual.
Likewise, just because a certain botanical or other naturopathic treatment is generally safe for the vast majority of patients does not guarantee that you are not the rare individual who is sensitive or allergic to such a substance.
Consequently, while the above provides a useful didactic introduction into common botanical insomnia treatment options, it does not constitute treatment advice, or even guarantee that all such treatments may be safely and effectively employed by all individuals.
If you are truly serious about your health, and interested in safe, effective, and lasting treatment for your insomnia - as well as for any other conditions you may wish to have treated - please contact a trusted and experienced healthcare professional.
Such a trusted and experienced healthcare professional will not only help you avoid adverse events and herb-drug interactions, but ensure that you receive the best treatment for your unique constellation of symptoms and conditions.
By identifying and targeting the core of your complaints, such professional, individualized naturopathic treatment avoids the ceaseless trial-and-error, escalating doses, dependence, and requirement for lifetime dosing associated with superficial treatment.
Ultimately saving time, money, and your health.
Your sleep has the ability to exert profound, all-encompassing effects on every aspect of your overall health and, consequently, on your physical, mental, and emotional well-being
Your quality of sleep determines your quality of health.
And your quality of health determines your quality of life.
So don't be penny-wise & pound-foolish.
Invest in your health, and you will reap the ongoing rewards in improved quality of life and happiness.
Fail to do so, and all your material possessions will pale in the face of chronic debility and dis-ease.
Whatever you decide, I will be here to assist you on your path to optimal, vibrant health.